#MyKidney biopsy results = I've physically lost 25% of healthy kidney tissue in my transplanted graft due to scarring from an as yet still unidentified cause.
The only knowns are that 1) my original kidney disease (FSGS) does not appear to be re-occurring at this time; 2) there is no evidence of acute rejection, but 3) the damage could be the result of an on-going "chronic rejection".
Most likely the damage has been slowly occurring (beginning sometime after my previous biopsy 18 months ago) while there were no clinical (or physical) symptoms. In this regard, kidneys are very resilient and can compensate for quite awhile before damaged tissue takes over and the remaining function can no longer shoulder the extra load. This is why there is most often a delay (even in cases where patients are watched very closely, like me) in the onset of clinical evidence of a problem until a somewhat significant amount of damage or kidney function has been lost.
For reference: A transplanted kidney should be functioning around 60-80% of 'normal' (what someone with healthy kidneys would naturally have)
My transplant is now functioning at around 40-45%. That's scary.
Where I go from here: In three weeks, after returning from my #WTFamI2 roadtrip, my transplant team will transition me to another class of anti-rejection medication in addition to adding an ACE inhibitor to my med list. The mindset behind this is that one of the anti-rejection medications I currently take (Prograf) and have taken since the first day of my transplant can actually cause kidney damage in people who are sensitive to it. Therefore, the transplanted kidney can become "poisoned" by the very medication that keeps the immune system from the body rejecting it. It's a catch 22.
By using another medication in lieu if Prograf it will eliminate at least one possible cause of the scarring and damage. It may or may not make a difference. It's a "wait and see".
In the meantime, it's one big game of "hurry up and wait".... seems to be the story of m life.